Anti-vax? It’s the heebie-jeebies

The vaccine-hesitant has butterflies in their stomach

Are you “vaccine-hesitant” or even an “anti-vaxxer” (gasp)? If you are, you probably believe you’ve done the research and come up with a perfectly rational reason for your position.

But you haven’t—not according to the very latest science, at least. No, you have the heebie-jeebies, formerly known as the collie-wobbles or, as doctors put it, “butterflies in the stomach” (Papilio stomachus). After analyzing the psychology of the “anti-vaxxer,” two researchers from the University of British Columbia have declared that’s really what’s going on.

Alan Richardson is a philosopher, so he really, really understands what makes us tick. And the other researcher, Judy Segal, is an English professor, so doubtlessly her skills came to the fore for that mot juste.

Writing in Canada’s most prestigious medical journal, the Canadian Medical Association Journal (CMAJ),¹ the two try to lead doctors away from their standard response to the vaccine-hesitant patient, “You’re a complete moron, mate,” and toward a more nuanced and empathetic approach.

The conventional view shared by almost all doctors is the “deficit model.” Sounds good, but it just boils down to this: People who are pro-vaccine are informed and responsible; ergo, the anti-vaxxer is ill-informed and irresponsible. A bit thick, in fact.

A more tolerant doctor might instead hold to “epistemic pluralism.” This recognizes that there are many different views and opinions out there, and although they are all completely wrong, it’s beholden on the epistemic pluralistic doctor to meet them “where they are.” To wade into the murky water of thickness, in fact.

Richardson and Segal are astonished that more doctors aren’t embracing epistemic pluralism but instead hold to the outmoded deficit model. “Just give the thickos a good kicking” seems still to be the order of the day.

Anti-vaxxers aren’t rational beings; they don’t actually think, the two explain. No, it’s all emotional, so it’s no good coming up with “the facts” (e.g., the mRNA Covid vaccines have been fully tested and are perfectly safe. Oh, and they stop you getting Covid and passing it on). No, the emotional anti-vaxxer needs cajoling just as you would a five-year-old.

“People who are skeptical about vaccines are not always waiting to be filled with information better than the information they have. Nor are they always people who can provide accurate and refutable explanations for their skepticism,” they write.

No, they don’t want superior information to dissuade them, and they have absolutely no idea why they hold their view, anyway. It’s just a bad case of the heebie-jeebies.

Richardson and Segal suggest a way of introducing the difficult subject of vaccination. A patient comes in, complaining about having had a bad back for weeks.

“Don’t worry about that,” the doctor responds. “Are you up to date with your vaccines?”

“No,” says the patient, “but I want my bad back sorted.”

“That’ll probably just clear up sometime (or not, haha), so . . . should I vaccinate you now?”

“No!” says the patient.

“It’s free,” the doctor says, “and it means millions of people won’t die, probably today.”

The doctor could also embrace a spot of epistemic pluralism to seal the deal: “Look, I know there are some who don’t believe in vaccines, but I know you’re not one of them because you’re not a moron.” That should be the clincher and send those heebie-jeebies scurrying back to where they came from!

Richardson and Segal admit, in passing, that the anti-vaxxer might have a point. “Of course, many people have entirely reasonable explanations for their vaccine skepticism, especially when they have had little cause for confidence in the institutions of government and medicine,” they write.

Having “entirely reasonable explanations” suggests the anti-vaxxers have thought it through and have developed rational reasons for their views. In fact, often they have done more research and are better informed than those who don’t question vaccines, and they’re not anti-vaxxers (a pejorative term) but pro-informed choice. On the other hand, people who get vaccinated sometimes do so from a sense of fear (viz Covid), which is an irrational response.

And fear is the crowbar that Richardson and Segal suggest doctors use on the vaccine-hesitant as a final resort: Your child could die if you don’t get vaccinated. You could lose your job. Entire populations could disappear. Your dog won’t want anything to do with you.

If all that fails, we need the anti-heebie-jeebie vaccine, and quick.

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